Mania and Hypomania Flashcards
What are the broad categories for symptoms of mania?
Biological
Cognitive
Psychotic
What is the difference between mania and hypomania?
Hypomania is mania without psychotic symptoms
What are some biological symptoms of mania?
Decreased need for sleep (few hours per night) Increased energy (increased in goal directed activity)
What are some cognitive symptoms of mania?
Elevated sense of self of delusions of grandeur
Poor concentration - difficult to maintain focus on just one thing
Accelerated thinking - Flight of ideas often, thoughts racing faster than they can express them, pressurised speech
Impaired judgement and insight - barrier to treatment
Compulsive behaviour (promiscuity, gambling)
What are some psychotic symptoms of mania?
Disordered thought form
Circumstantiality - focus of conversation drifting but does come aback to point
Perceptual disturbance (hyperacusis - things seeming louder)
Hallucinations - visual or auditory
***these psychotic symptoms are what differentiate between mania and hypomania
If someone presents with manic symptoms what sort of diagnoses should we be considering?
BAD
Hypomanic, manic or mixed affective disorders
CYCLOTHYMIA or DYSTHYMIA - intermittent episodes of elevated mood or low mood that are not severe enough to meet criteria or mania or depression
What are some medical causes of mania?
Cerebral neoplasms or infarcts Trauma, infection (HIV) Cushing's disease Huntington's disease Hyperthyroidism MS Renal Failure SLE Temporal lobe epilepsy Vitamin B2 and niacin deficiency
What substances can cause mania?
Amphetamines, anticholinergics, antidepressants, Antivirals, antimalarials, captopril, Cimetidine, cocaine, corticosteroids, hallucinogens, L-Dopa
What investigations should be done in a patient with mania?
MSE
Bloods: FBC, U&E, TFT, LFT, B12 and folate
Urine - dip and drug screen
How should mania be managed?
It cannot be managed in primary care and must be referred to CMHT - the first line of therapy is lithium.
